How is hepatitis C virus spread and how can transmission be prevented?
Hepatitis C is spread (transmitted) most efficiently through the blood. Therefore, hepatitis C virus is transmitted by infected blood or blood products, transplantation of infected solid organs (e.g., liver, kidney, heart), and the sharing of contaminated needles among intravenous drug users. In retrospect, hepatitis C virus was the most common cause of hepatitis that resulted from blood transfusions in the 1980's. At that time, hepatitis C virus had not yet been identified and post-transfusion cases of hepatitis were called non-A non-B hepatitis.
In the early 1980's, the risk of contracting hepatitis C virus from a blood transfusion was as high as 15%. In the mid 1980's, when the practice of using commercial (paid) donors was stopped and blood was screened for the human immunodeficiency virus (HIV), the risk of post-transfusion hepatitis fell to about 5%. This risk was then cut in half when blood was screened with the substitute (surrogate) markers, elevated alanine aminotransferase (ALT, the liver enzyme), and hepatitis B core antibodies. Finally, the isolation of the hepatitis C virus and the development of a screening test for hepatitis C virus dramatically lowered the risk of acquiring hepatitis C virus infection through blood transfusions.
All blood donors are currently screened with the following panel; hepatitis C antibodies, hepatitis B surface antigen, hepatitis B core antibodies, elevated alanine aminotransferase, HIV antibodies, and syphilis. As a result, the risk of contracting hepatitis C virus from a single unit of blood is less than 1:100,000. This risk will be even lower one day when tests that measure minute quantities of hepatitis C viral nucleic acids are universally adopted for blood screening.
Today, hepatitis C virus is most commonly transmitted by intravenous drug abuse, which accounts for about 60% of new cases. Moreover, 50 to 60% of new intravenous drug users are infected within the first 6 months of use, and nearly 90% are infected by one year. Other types of illegal drug usage, such as snorting cocaine, have also been associated with an increased risk of acquiring an hepatitis C virus infection.
Hepatitis C virus can be sexually transmitted, but not very efficiently. Hepatitis C virus has been isolated in the semen, vaginal fluid, and saliva. Nevertheless, the risk of transmission of hepatitis C virus from an infected individual to a non-infected spouse or partner without the use of condoms over a lifetime is only about 1 to 4%. The Centers for Disease Control (CDC) and Prevention has not recommended using a barrier technique (for example, condoms) for hepatitis C virus infected individuals in a long-term monogamous relationship. On the other hand, individuals with multiple sexual partners should definitely use condoms. Furthermore, the practice of safe sex is key in preventing the transmission of other sexually transmitted diseases, such as HIV and hepatitis B.
Food, water, breast-feeding, sneezing, coughing, hugging, casual contact, or sharing eating utensils or drinking glasses have not been shown to spread hepatitis C. What's more, hepatitis C is not transmissible by kissing, unless an open wound is involved. However, to further recognize that hepatitis C is transmitted through blood, the sharing of razors and toothbrushes should be avoided.
Interestingly, the CDC has not found a definite association between tattoos and the transmission of hepatitis C virus. It is critical, nevertheless, that appropriate precautions be taken in applying tattoos, including the artist wearing gloves and using disposable equipment. In contrast to hepatitis B, the transmission of hepatitis C from the mother to the newborn around the time of delivery is unusual.
Hepatitis C virus infection can also be acquired through occupational exposures. Thus, health care workers in contact with contaminated bloods, fluids, and needles are at an increased risk for hepatitis C virus. The risk of acquiring hepatitis C virus from a needle stick involving an individual who has detectable virus in the blood is as high as 5% and about 2% on the average. The risk is higher if a hollow bore needle makes the needle stick since the potential for a greater amount of blood is higher with this type of needle. In the medical setting, patients receiving hemodialysis and medical providers in renal dialysis units have a higher frequency of hepatitis C virus infection than people in the general population.
What else can be done to prevent hepatitis C? Immune serum globulin, given after an exposure to hepatitis C virus, would not be expected to protect a susceptible individual from acquiring an hepatitis C virus infection. Moreover, no vaccine is currently available for hepatitis C virus. It should be noted, however, that hepatitis A and B vaccinations are recommended for patients who have hepatitis C virus liver disease. As already mentioned, intravenous drug abuse remains the most common mode of transmission of hepatitis C. Ideally, users should stop using drugs and enter a rehabilitation program. However, active users of drugs should not reuse or share needles, syringes, water, and other materials.
2006-06-21 05:49:37
·
answer #1
·
answered by WiserAngel 6
·
5⤊
1⤋